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HomeMy WebLinkAbout09208 (BLCK)44435 Marigold Lane 09208 09167 09228 P.O. BOX 1504~ No. Building 78-105 CALLE ESTADO - Address 44-425 Mariaold Lane LA QUINTA, CALIFORNIA 92253 Owner ,- a .:-. _ t BUILDING: TYPE CONST. OCC: GRP. Mailing y Address same A.P. Number City Zip 77- Legal Description Contractor Project. Description 91• •7 f-rf 6% a h1eick TvrAI I -Address. 49-125 T ancro Coiiit i -City Zip Tel State ic. w. - - City t :: & Classif. ' ' Lic. # Sq. Ft. No No. Dw. Arch:, Engr., B' C '2,9 5512l 1812 Size Stories': Units Designer. New ❑ Add ❑;Alter ❑ Repair ❑. ' Demolitiori ❑. Address Tel. City Zip State Lic. # - LICENSED.CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section `-_ W, _ 7000)•of.Di•vision 3 of the,Business and Professions Code, and my license is in full force and effect. '""' "` 1GNATURE DATE - OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor s=License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any'•cfy or county which requires a. permit to construct, alter, improve, demolish, or repair any structure,. Qrior to its issuance also - ..AMOUNT a'requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT .- r . •' the provisions• of the Contractor's License Law, • Chapter 9 (commencing with Section 7000) o/ - ' - Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis - for the alleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. " ' subjects the applicant to a civil penalty o/ not more than five hundred dollars ($500). _ Plan Chk• Bal. .❑ I, as owner,ofthe property, or.my employees,with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 'p " Professions Code: The. Contractor's. License Law does not apply to an owner o/ property .who .builds or improves thereon and _who does such work himself or through his own employees, M@CIi. _Pro vided.that:such improvements are not intended or offered for safe' 1/, however,. the building • _ , or improvement is sold within one year of completfon, the owner -builder will have ,the burden Electrical - Cproving.that he did not build or improve../or the purposeo/ sale.) - ' O I, as owner of the property, am exclusively contracting with licensed contractors to con Plumbing strucI the project. (Sec. 7044, Business and Pro/essions Code:. The Contractor's License Law _ ;. does not apply to an owner o/ property who builds or improves thereon, and who contracts for _ S.M.I. 07 such 'projects with a contractors) licensed pursuant to the Contractor's License Law.) -• Grading ❑ 1 am exempt under Sec.' B. & P.C. for this reason Driveway Enc. ; Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION. I hereby affirm that I have a certificate of consent to self -insure,' or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company O Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM r WORKERS' COMPENSATION INSURANCE r (Thin section need not be completed if the permit is for one hundred dollars ($100) valuation ' or less:)ce- •'I •rtify that in the performance of the work for which this permit is issued, I shall not employany Laws of Californiaperson in any manner so as to become subject to the Workers' Compensation TOTAL 1 2 1 I. REMARKS ' inti LR RC`Ati'!_4 "TA674flzoi5 ate Owner NOTICE TO APPLICANT: I/, alter making this Certificate of Exemption you should become ZONE: - - .' BY:. •= subject to the Workers' Compensation provisions of the Labor Code; you must forthwith comply with such provisions or this permit shall be deemed revoked. .. Minimum Setback Distances:' ' - - , Front Setback from Center Line - - - Rear Setback from Rear Prop. Line - CONSTRUCTION LENDING AGENCY. Side Street Setback.frOm Center Line hereby affirm that there is a construction lending agency for the performance of the _work for which this permit is issued. (Sec..3097,.Civil Code.). ,. Side Setback from. Property. Line - - Lender's Name _ X Lender's Address ` ' FINAL DATE INSPECTOR This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for. 180 days. •I certify that I have read this application and state that the above information is correct.. Issued by: Date - Permit I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives 'of this city to enter the above. > mentioned property for inspection purposes. Validated by: - Signature of applicant Date " Mailing Address Validation. City, State, Zip , i y. y T ,y -! ..,' 'y- T „C ]A L Y - i+'r"T • ,.-t i _ '. Y ::: r - ' y i .'v • •%. ! V .` F i •J..iJ ..:at ! } ' Y Sf}'f :-F'4 2''' 1• 4• t '.' ce:i. F .y. =4 - S"ir .,. • Y rK _ Y'tf r+? x . 14a " ' C+;iF 1, ! r .: +. xT'eA'". :4r .r , n - CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. Ff. WALL SO. FT. ® SO FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. Ff. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1//. c SEWAGE DISPOSAL SO.Fi.GAR ® 3/ac HOUSE SEWER REMARKS: GAS PIPING PERMIT FEE PERMIT FEE:d PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. ( GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP, FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL